A Prospective, Double-Blind, Randomized Controlled study Assessing the Perioperative Glycemic Response following Two Doses of Dexamethasone for Postoperative Nausea and Vomiting Prophylaxis in Gynecological Laparoscopic Surgeries.

Double blinded, randomized, controlled study,Written informed consent will be taken from willing patients posted for elective surgery under general anesthesia. Pre operative blood sugar values will be documented along with age, gender,body mass index, type of surgery.Double blinding will be ensured by using preloaded 2 ml syringe of dexamethasone of 4 mg (groupA) and Dexamethasone 8mg (group B), prepared by an anesthesia resident unaware of allocation, after the opening of a sealed opaque envelope containing the randomized assignment. Patients will be allocated in 2 groups: non-diabetics receiving Dexamethasone 4mg ; Non diabetics receiving dexamethasone 8mg.The study drug will be administered after induction of anesthesia. No dextrose containing solution will be administered during the study. In the OT after attaching standard ASAmonitors, anesthesia will be induced with propofol iv after premedication with intravenousglycopyrrolate, Midazolam, ondansetron 4mg, fentanyl. Muscle relaxation will be achieved with atracurium 0.5mg/kg and endotracheal intubation done. At the end of surgery patients will be extubated after reversal of neuromuscular blockade. For the patient intraoperatively blood glucose monitoring will be done as per protocol.All blood glucose levels will be measured using a calibrated glucometer, SD code free (SD Biosensor,Inc.).The blood glucose measurements will be obtained from finger prick capillary blood samples, by anaesthesiology resident blinded to study group The total amount of insulin administered for the treatment of perioperative hyperglycemia will be recorded .

Blood sugar values after dexamethasone administration on POD 1,2,3 will be taken as primary endpoints.

PONV will be assessed using a 4-point verbal descriptive scale which consists of score 0=no

PONV, score1 = mild PONV: patient complaints of nausea but refuses antiemetic treatment, score 2

= moderate PONV: patient complaints of nausea and needs antiemetic treatment; score 3= severe

PONV.

Patients who experience PONV in the recovery area will be treated with

intravenous metoclopramide (10 mg)